Prompt and Intensive Antiviral Chemoprophylaxis in Nursing Home Influenza Outbreaks

Is initiation of antiviral chemoprophylaxis with oseltamivir for 70% or more of eligible nursing home (NH) residents within 2 days of outbreak detection associated with lower 14-day and 30-day mortality and hospitalization compared with a nonintensive approach?In this cohort study of 404 influenza outbreaks across 318 NHs with 35 086 resident-trial observations using a sequential target trial emulation and the randomize-censor-weight approach, hospitalization but not death was lower at 14 days post outbreak in NHs that implemented intensive antiviral chemoprophylaxis; 30-day estimates were directionally similar but less precise.Results of this study suggest that clinicians should promptly initiate antiviral chemoprophylaxis in at least 70% of NH residents within 2 days of an influenza outbreak to markedly reduce influenza-related hospitalizations.

Corresponding Author: Andrew R. Zullo, PharmD, PhD, Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Box G-S121-2, Providence, RI 02912 (andrew_zullo@brown.edu).

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